2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

노인의 영적 간호요구

최미혜,김경희,김귀옥,김기숙,김수강,김정신,김춘숙,노흥진,박지연,성혜연,오명선,이선희,이원옥,이윤영,이현수,장명재,차혜경,채정선,홍상희 중앙대학교 의과대학 간호학과 간호과학연구소 2001 중앙간호논문집 Vol.5 No.1

This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.

시중 절임배추의 품질 평가

김진희 ( Jin Hee Kim ),박건영 ( Kun Young Park ),최혜선 ( Hae Sun Choi ),양지영 ( Ji Young Yang ) 한국식품영양학회 2010 韓國食品營養學會誌 Vol.23 No.4

This research aimed to investigate the quality of conventional salted cabbages. Here, we studied the general characteristics and microbiological aspects of purchased salted cabbage samples from 15 companies. The purchased salted cabbages used a sun-dried salt, but two samples used a mixture of sun-dried salt and processed salt. There were 4 times of washing, 3 steps of washing after automatic washing, and 3 steps of washing after bubble washing as washing methods for the salted cabbages and ground water was used as the washing water. Also, three samples received HACCP certification. The salt contained in the purchased salted cabbages ranged from 0.5% to 2.0%, representing low salted cabbages. The pH of the purchased salted cabbages ranged from 5.32 to 6.47, and hardness ranged from 1,997g to 3,665g. Rewashing was necessary before using some salted cabbages due to foreign materials such as insects, soil, etc. Total bacterial counts of the purchased salted cabbages ranged from 3.36 log to 6.06 log and coliform bacteria ranged from below 1 log to 6.05 log, whereas other pathogens were not detected.

초·중·고등학교 학생·학부모·일반교사의 보건교육 영역별 요구도와 보건교육

윤순녕,김영임,최정명,조희순,김영희,박영남,오경순,이분옥,조선녀,조소영,한선희,하영미 韓國學校保健學會 2005 韓國學校保健學會誌 Vol.18 No.1

Purpose: The purpose of this study was to identify the needs of health education in students, their parents and teachers in the elementary, middle and high schools and the current situation of health education class. Method: The subjects of this study were a total of 9450 persons including students, their parents and teachers from 279 schools throughout the country. They were selected through convenient sampling. Data were analyzed through x^(2)­test and ANOVA. Result: Students, their parents and teachers replied that 18 dimensions of health education class (DHEC) are necessary. The four DHEC - healthier life style, sex education, mental health and safety education - showed high educational needs in students, their parents, and teacher. High school students had higher educational need of 'symptom management for daily living' than elementary and middle school students. Students, their parents and teachers in elementary school had higher educational needs of 17 DHEC that those in middle and high school. The percentages of schools with health education class taught by health teachers were 99.2%, 75.5% and 66.0% respectively in elementary, middle and high schools. Health education was given mainly using physical education classes at elementary schools, and creative class hours at middle and high schools. In general, health education took 1-3 hours per week at elementary schools, and less than an hour at middle and high schools. Conclusion: Therefore, based on the results, systematic health education class should begin from elementary school to meet the need of health education in students, their parents and teachers, and further study should be made on the number of hours required and the amount of contents of 18 DHEC.

초·중·고등학교 학생, 학부모, 일반교사의 보건교육 요구

윤순녕,김영임,최정명,조희순,김영희,박영남,오경순,이분옥,조선녀,조소영,한선희,하영미 韓國學校保健學會 2004 韓國學校保健學會誌 Vol.17 No.2

Purpose : The purpose of this study was to identify needs of health education of the students, parents, general teachers, and health teacher of the elementary, middle, and high schools. Method : 279 schools of elementary, middle, and high school were sampled nonproportionally during the period from June 28 to July 26, 2004 . The data were collected by the questionnaire from 1,888 students, 1,876 parents, 1,695 general teachers, 279 health teachers. A frequency, % and χ2-test were used to analysis by SAS program. Result : 1. It showed that 98.1% of elementary school students, 92.3% of middle school students, 89.6% of high school students answered that they need health education. The most of students, parents, and general teachers had high interests in health education. 2. In the case of students, main causes of needs of health education was 'to prevent diseases or accidents''. But parents answered that it was 'to build up a healthier behavior'. General teachers answered that it was 'more effective systematic and continuous health education'. 3. Over 80% of students, parents, and general teachers about the question of who qualified person is to teach health education as a regular class responded that health teacher is available. Especially 93% of elementary school students answered like that. 4. The most of students, parents, and general teachers answered that health education in the classroom is favorable 1 to 2 hours per week. Conclusion : As results of the study , the majority of students, parents, general teachers agreed needs of health education. Therefore, on the basis of this study, systematic and continuous health education is necessary. Additionally the establishment of independent health subject is required certainly.

일부지역 중·고등학생들의 흡연실태 조사연구

신옥순,남철현,김복용,최연희,박선희,박경옥,구재희 慶山大學校 保健福祉硏究所 2002 保健福祉硏究 Vol.7 No.-

This study was conducted to examine aspects of middle and high school students' drinking and smoking with analysis of related factors. The subjects of this study was 540 students in Kyungbuk Province. Data were collected from July, 2002 to September, 2002. The results of this study can be summarized as follows. 1. 43.6% of the boy students experienced smoking, while 12.2% of the girl students experienced it. 5.3% of the students at academy schools experienced smoking, while 44.7% of the students at vocational schools experienced it. 11.4% of the middle school students experienced smoking, while 33.9% of the high school students experienced it. 15.5% of them who lived in towns or villages experienced smoking and 38.3% of them who lived in small or medium sized cities experienced it.37.5% of the students who belonged to the lower economic class experienced smoking and 20.7% of the students who belonged to the upper economic class experienced it. 24.0% of the students who belonged to the middle economic class experienced it. It appears that the respondents showed significantly different smoking experience rates by gender, school types, grades, the number of family members, residences, and economic classes. 2. 14.5% of the respondents who lived with grandparents and parents experienced smoking and 26.5% of them who lived with parents experienced it. The smoking rate was significantly high in the groups of having one-parent, being unsatisfied with family life, making poor grades in studies, and having the father or the mother working as a salesperson. 3. 45.3% of the respondents who were unsatisfied with family life experienced smoking. The smoking rate of the respondents who were unsatisfied with it was significantly higher than that of the other groups. On the other hand, the smoking rates were not significantly different by daily life, schoolmate relation, health condition, and feeling stress. 4. According to smoking rate by frequency of drinking, 16.4% of the respondents who drank less than once a month smoked and 54.8% of them who drank more than twice a month smoked. The more frequently they drank, the higher their smoking rate was. Those who did exercise displayed significantly higher smoking rate than those who did not do exercise. Among the rates of the respondents' agonies, family disharmony was 50.5% and love problem was 39.2%. Economic condition preblem was 34.6%. It appeared that smoking was most influenced by the family disharmony. 5. The factors significantly influencing smoking experience were gender, school grade, schoolmate relation, score in studies, and exercise. From above results, it can be concluded that the students' smoking is a serious problems which can be resolved by simple approaches because it is interrelated complicatedly with gender, grade, family, school, etc. Schools, related organizations, and the government must closely work together to maximize the effectiveness of policy implementation concerning the smoking and drinking problem of the middle and high school students.

Benz[f]indole-4,9-dione 유도체의 Topoisomerase I-DNA에 대한 결합형태와 저해작용 간의 상관관계

최인희,우선아,박혜숙,박혜영,김춘미 이화여자대학교 약학연구소 2005 藥學硏究論文集 Vol.- No.16

We present binding modes of newly eethesized benzlflindole4,94ione analogs with topoisomerase I (TOPI)-DNA complex The compounds were tested for cytotoxicity and 10pl inhibitory activity in our previous study. Camptothecin (CPI) and each of the 15 analogs were docked into the X-ray crystal stucture of human TOPI-DNA binary complex to develop the temary complex of TOP1-DNA-ligand using FlexiDock The results demonstrated that two compounds with N_(1)-attached halogens intercalated exactly between the -1 and +1 DNA bases, deeply toward the cleavage site and were stabilized by three H-bonds each and an array of hydrophobic interactions with both the enzyme and the DNA. The most potent intbiery activities they showed in the test agree well with the proper docking results. Six compounds which did not intenalate and formed no H-bond showed no or very low inhibitory activities. Seven compounds that intercalated between the bases with one to four H-bonds but not deeply enough toward the cleavage site showed intermediate activities. The structure-activity relationship was consistent with the experimental data The ternary complex presented potential binding mode of each compound and thus could provide a rational basis far novel inhibitor design to develop potent anticancer drugs targeting TOP1 enz[f]indole-4,9-dione 유도체와 topoisomerase I(TOP1)-DNA 복합체의 결합형태를 규명하기 위해 세포독성과 TOP1저해작용이 검사된 15개의 유도체와 camptothecin을 TOP1-DAN복합체의 X-선 구조에 FlexiDock을 사용하여 docking하였다, 그결과 N_(1)에 할고겐 이 결합된 두화합물은 -1/+1 염기 사이에 끼어들어 깊숙이 결합되었고 각각 3개의 수고결합과 다수의 소수성 상호작용으로 안정화되었다. 활성검사에서 가장 강한 작용이 나타나 고유한 docking결과와 잘 부합되었다. 염기사이에 끼어들지 않고 수소결합도 형성하지 않은 6개의 화합물에서는 활성이 거의 나타나지 않았다. 한개 내지 4개의 수소결합을 형성하면서 염기 사이에 끼어들었으나 TOP1에 의해 잘라지는 위치에 깊게 결합하지 못한 7개의 화합물은 중간 정도의 활성을 나타내어 구조 활성 관계가 실험 치와 잘 일치 하였다, 이 결과는 TOP1을 목표로 하는 새로운 항암제의 구조를 고안하는데 합리적인 근거를 제공할 것이다.

고춧가루내의 고추씨 함량이 김치발효와 항돌연변이 활성에 미치는 영향

최선미,전영수,이숙희,박건영 부산대학교 김치연구소 2002 김치의 과학과 기술 Vol.8 No.-

The fermentation characteristics such as pH, acidity, lactic acid bacterial counts and panel taste of kimchi, and antimutagenic activity of kimchi were studied when the kimchi prepared with different ratio of seed (S) pericarp (P) in red pepper powder and fermented at 15℃. The pHs of P:S = 9:1 kimchi and P:S = 7:3 kimchi decreased gradually during the kimchi fermentation, however, pHs of P:S = 5:5 kimchi and P:S = 3:7 kimchi decreased very fast during the fermentation. The counts of Leuconostoc sp were high in P:S = 9:1 kimchi and P:S = 7:3 kimchi but the levels were low in P:S = 5:5 kimchi and P:S = 3:7 kimchi. Whereas Lactobacillus sp counts were low in P:S = 9:1 kimchi and P:S = 7:3 kimchi, but the counts were high in P:S = 5:5 kimchi and P:S = 3:7 kimchi during the fermentation. P:S = 3:7 kimchi showed the highest prevalence in the panel taste of the kimchis and the P:S = 3:7 kimchi resulted in the lowest prevalence. The antimutagenic activities of the kimchi juices were studied by Ames test using Salmonella typhimurium TA100 and SOS chromotest using E. coil PQ37. As the ratio of the seed increased, the antimutagenicities increased. Among the kimchi samples, P:S = 5:5 kimchi significantly reduced (p<0.05) the mutagenicities induced by aflatoxin B_1(AFB_1) in Ames test and SOS response against N-methy1-N'-nitro-N-nitrosoguanidine (MNNG) in SOS chromotest. From the results of the experiments, the P:S = 7:3 kimchi seems to be the best seed ratio of red pepper powder for the preparation of kimchi in terms of fermentation characteristics and antimutagenicity of the kimchi.

조혈모세포이식 환자에서 발생한 Cytomegalovirus 질환의 특징 : 일개 대학변원에서 최근 10년간의 경험

최수미,이동건,박선희,김시현,김유진,민창기,김희제,이석,최정현,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2009 감염과 화학요법 Vol.41 No.1

Background : Studies on cytomegalovirus (CMV) diseases in Korean hematopoietic stem cell transplant (HSCT) recipients are lacking and do not reflect the recent trends of advances and changes. Therefore, we tried to analyze the clinical features of CMV diseases in HSCT recipients over the past 10 years at a tertiary university hospital in Korea. Methods : Retrospective review of medical records was done for all adult HSCT patients who received transplant at the Catholic HSCT Center from January 1998 to January 2008. Results : Forty-four cases (2.2%) of CMV diseases were identified. CMV pneumonia was diagnosed in 17 patients, retinitis in 16 patients, enterocolitis in 7 patients, esophagitis 1 patient, gastritis in 1 patient, duodenitis in 1 patient, and hepatitis in 1 patient. The median onset of symptom was 90 days after transplantation. Late CMV diseases accounted for 47.7%. CMV related death varied from 0 to 58.8% according to the involved organ. CMV retinitis was diagnosed relatively later in the course of transplantation mostly in patients who had chronic graft versus host disease (GVHD). On the contrary, CMV enterocolitis mainly occurred in patients who suffered from acute GVHD. The overall concurrent CMV reactivation was documented to be 63.6%: the concurrent CMV reactivation was observed only in 37.5% of patients with retinitis. Conclusions : We observed some differences in the pattern of CMV disease manifestation according to the involved organ and reconfirmed the fact that CMV pneumonia is the most common and fatal disease in HSCT recipients. Additionally, CMV retinitis was not uncommon in HSCT recipients. Since specific marker does not exist in predicting retinitis, regular ocular examination should be done thoroughly, especially in patients with chronic GVHD.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 이트라코나졸 액과 플루코나졸 시럽의 예방 효과 : 전향적, 무작위, 비교 임상시험

최수미,이동건,최정현,박선희,엄기성,김유진,김희제,민창기,유진홍,김동욱,이종욱,민우성,신완식,김춘추 대한감염학회 2005 감염과 화학요법 Vol.37 No.2

목적 : 조혈모세포이식 환자에서 호중구 감소 기간 동안 이트라코나졸 액(ITZS)과 플루코나졸 시럽(FCZS)의 진균 감염에 대한 예방 효과를 전향적으로 비교해 보고자 하였다. 재료 및 방법 : 2001년 8월부터 2002년 6월까지 가톨릭 조혈모세포이식센터에 입원하여 동종 조혈모세포이식을 받은 만 18세 이상의 환자들을 각각 ITZS와 FCZS군으로 무작위 배정하여 침습성 진균 감염 발생과 약제 관련 부작용을 전향적으로 조사하였다. 결과 : ITZS군에 40명, FCZS군에 38명이 배정되었고, FCZS군 환자의 평균 나이가 더 많았다. 시험 약제 평균투여기간은 ITZS군 16.4일, FCZS군 21.9일로 ITZS군이 더 짧았다. 이는 ITZS군에서 소화기 부작용으로 인한 약제 중단이 더 많았기 때문으로 보인다. 시험 약제 투여 후 총 빌리루빈 수치의 유의한 증가가 관찰되었으나, 약제 관련 부작용은 모든 환자에서 가역적이었다. 호중구감소 기간동안 표재성 진균 감염은 두 군에서 모두 발생하지 않았고, 침습성 진균 감염은 ITZS군 5명(12.5%), FCZS군 8명(21.1%)으로 FCZS군에서 많았으나, 통계학적으로 유의하지 않았고, 사망률에도 유의한 차이는 없었다. 결론 : 침습성 진균 감염에 대한 이트라코나졸 액과플루코라졸 시럽의 예방 효과에 유의한 차이는 없었으나, 앞으로 더 많은 환자를 대상으로 잘 짝지어진 대조군 연구가 필요할 것으로 보인다. 부작용 중 간독성과 관련하여 이식시 투여되는 여러 약제들과의 상호작용에 대한 연구도 필요할 것이다. Background : Though fluconazole is widely used for antifungal prophylaxis, it is ineffective against mould infections including Aspergillus species. Itraconazole has a broader spectrum than fluconazole but the capsule form shows erratic bioavailability in neutropenic patients. In this study, we compared itraconazole oral solution (ITZS) with fluconazole syrup (FCZS) for the prevention of invasive fungal infection (IFI) in allogeneic hematopoietic stem cell transplant recipients. Materials and Methods : Adults receiving allogeneic hematopoietic stem cell transplantation (HSCT) from september 2001 to June 2002, were randomly allocated to either the ITZS group or the FCZS group. We prospectively evaluated the safety and efficacy of each drug. Results : Out of 78 patients (40 patients in the ITZS group and 38 patients in the FCZS group) who were eligible for this study, 37 patients completed the course of prophylaxis without any evidence of IFI. The mean duration of prophylaxis was 16.4 days for the ITZS group and 21.9 days for the FCZS group (P<0.006). Drug-related adverse events occurred in 28 patients (70.0%) and 19 patients (50.0%) in the ITZS group and the FCZS group, respectively. Common adverse events of ITZS were nausea, vomiting, and diarrhea. Drug-related reversible hepatotoxicity occurred in 4 patients in the ITZS group. There was a significant elevation of total bilirubin level in the ITZS group. The incidence of suspected IFI occurred in 5 patients (12.5%) who received ITZS, compared with 8 (21.1%) who received FCZS (P=0.372). There were no proven IFIs or superficial (oral/vaginal) fungal infections in both groups. Overall mortality was not different between the two groups (2.5% in the ITZS group versus 5.3% in the FCZS group, P=0.610). Conclusion : ITZS and FCZS showed similar protection against IFI during pre-engraftment period. Poor tolerability due to gastrointestinal troubles of ITZS might limit its success as prophylactic therapy. Well matched controlled study with large number of patients will be required in the future.